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Stroke in the medical intensive-care unit
1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clinic Proceedings
|July 15, 1998
Summary
New-onset stroke in critically ill patients is rare and often fatal. Disseminated intravascular coagulation is a key cause, with coma being a common initial symptom.
Area of Science:
- Neurology
- Critical Care Medicine
- Vascular Neurology
Background:
- Stroke is a critical complication in critically ill patients.
- Understanding the incidence and outcomes of stroke in this population is vital for improving patient care.
Purpose of the Study:
- To investigate the occurrence and outcomes of new-onset stroke in patients admitted to a medical intensive care unit.
- To identify common etiologies and clinical manifestations of stroke in critically ill patients.
Main Methods:
- Retrospective review of medical records for patients admitted to medical intensive care units between 1985 and 1995.
- Analysis of computed tomographic scans or scan reports to confirm stroke diagnosis and type.
Main Results:
- Nineteen patients with critical medical illness experienced new-onset stroke.
- Ischemic stroke occurred in 10 patients (8 with bihemispheric infarction), with disseminated intravascular coagulation as a common cause.
- Hemorrhagic stroke occurred in 9 patients, often linked to disseminated intravascular coagulation or mycotic aneurysms.
- Seventeen of 19 patients died, and 2 had severe disabilities.
Conclusions:
- Coma is a frequent initial sign of stroke in critically ill patients.
- Disseminated intravascular coagulation plays a significant role in the etiology of stroke in this cohort.
- New-onset stroke in critically ill patients is typically a terminal complication.